亚砷酸联合沙利度胺治疗难治性复发性多发性骨髓瘤的疗效  

Effects of arsenic trioxide combined with thalidomide for the treatment of relapsed/refractory multiple myeloma

作　　者：程晓文[1] 陈瑜[2] 王焰[2] 蒋克敏 顾海蔚[1] 陈钰[2] 沈志祥[2] 

机构地区：[1]上海瑞金医院集团闵行医院血液科,201199 [2]上海交通大学医学院附属瑞金医院血液科

出　　处：《白血病．淋巴瘤》2012年第1期47-49,共3页Journal of Leukemia & Lymphoma

摘　　要：目的观察亚砷酸（ATO）联合沙利度胺治疗难治性复发性多发性骨髓瘤（MM）的疗效和安全性。方法35例难治性复发性MM患者，给予ATO（10mg／d）及维生素C（2g／d）静脉滴注，连续应用14d，每28d为1个疗程；同时给予沙利度胺口服，起始剂量为50mg／d，1周后逐步加量并调整至100～150mg／d，长期维持。连续应用3个疗程后评估疗效和患者不良反应，有效患者继续沙利度胺维持治疗，并随访观察无进展生存（PFS）。采用参照欧洲血液和骨髓移植小组骨髓瘤疗效判定标准判定疗效，并按世界卫生组织（WHO）标准判定不良反应。结果ATO联合沙利度胺治疗难治性复发性MM总有效率71．43％（25／35），完全缓解2例（5．71％），部分缓解12例（34．29％），微小反应11例（31．43％），无效10例（28．57％）。25例患苦进入维持治疗后，中位随访期为11个月（2～31个月），中位PFS9个月。主要不良反应有消化道反应、白细胞减少、肝功能损害、手足麻木等，不良反应轻微，均可耐受。结论ATO联合沙利度胺治疗难治性复发性MM有效、可行，并有较好的治疗顺从性。Objective To evaluate the efficacy and side effects of arsenic trioxide （ATO） combined with thalidomide in the treatment of relapsed/refractory multiple myeloma （MM）. Methods 35 patients with relapsed/refractory MM were treated with ATO （10 mg/d） and Vit C （2 g/d） for 14 days, 28 days per cycle. Meanwhile they were orally administered thalidomide 50 mg/d, and then one week later orally thalidomide was added to 100-150 mg/d. After 3 cycles of treatment, response and the side effects were evaluated. Patients responsed to the regimen were continued the treatment of thalidomide and were followed up to estimate the PFS. Responses were assessed according to the criteria of the EBMT. Adverse events were graded according to the criteria of the WHO. Results The overall response was 71.43 % （25/35）, CR 5.71% （2/35）, PR 34.29 % （12/35）, MR 31.43 % （11/35）. After a median follow-up of 11 months, the median PFS was 9 months. The major adverse reactions were digestive tract reaction, leukocytopenia, liver function damage, peripheral neuropathy. They were mild,and could be tolerated. Conclusions The combination of ATO and thalidomide is a feasible and active regimen in treatment of relapsed/refractory MM with better compliance in general.

关 键 词：亚砷酸 沙利度胺 多发性骨髓瘤 难治性复发性 

分 类 号：R733.3[医药卫生—肿瘤]